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在接受标准血液透析或家庭夜间血液透析的患者中,对氧磷酶1的芳基酯酶活性和质量降低,且与C反应蛋白呈负相关。

Paraoxonase 1 arylesterase activity and mass are reduced and inversely related to C-reactive protein in patients on either standard or home nocturnal hemodialysis.

作者信息

Kannampuzha J, Darling P B, Maguire G F, Donnelly S, McFarlane P, Chan C T, Connelly P W

机构信息

Keenan Research Center, Li Ka Shing Knowledge Institute, Ontario, Canada.

出版信息

Clin Nephrol. 2010 Feb;73(2):131-8.

Abstract

UNLABELLED

Human serum paraoxonase (PON1) activity is reduced in standard hemodialysis (SHD) (4 hours, 3 days/week) patients. Home nocturnal hemodialysis (HNHD) (8 hours, 6 days/week), provides a greater dialysis dose resulting in a greater clearance of metabolites. Whether improvements in the metabolic milieu of HNHD patients results in different PON1 activity levels compared to SHD patients is unclear. We determined serum PON1 mass and arylesterase activities in a group of HNHD patients and compared them to SHD patients and a group of healthy controls (HC).

PATIENTS AND METHODS

We measured PON1 arylesterase activity and mass, C-reactive protein (CRP), cystatin C, total and high-density lipoprotein (HDL) cholesterol, triglycerides, apolipoproteins A-I and B in 15 HNHD, 15 SHD and 15 HC participants.

RESULTS

PON1 arylesterase activity (p < 0.001) and mass (p < 0.05) were significantly higher in HC participants compared to SHD and HNHD participants, although no significant differences were noted between HD groups. CRP (p < 0.05) was significantly higher in SHD compared to HC participants and there were no significant differences noted between HD groups. Cystatin C (p < 0.001) was significantly different among the 3 groups. There were no significant differences noted in any lipoprotein parameters among the groups. PON1 activity (r = -0.636, p < 0.001) and mass (r = -0.425, p = 0.019) were inversely correlated with CRP in HD patients.

CONCLUSION

PON1 is reduced in HNHD patients compared to HC subjects, independent of the concentration of HDL cholesterol. Within subjects on HD, the combination of increased CRP and reduced PON1 may identify subjects at a high risk for cardiovascular complications.

摘要

未标记

在接受标准血液透析(每周3天,每次4小时)的患者中,人血清对氧磷酶(PON1)活性降低。家庭夜间血液透析(每周6天,每次8小时)可提供更大的透析剂量,从而使代谢产物的清除率更高。与接受标准血液透析的患者相比,家庭夜间血液透析患者代谢环境的改善是否会导致不同的PON1活性水平尚不清楚。我们测定了一组家庭夜间血液透析患者的血清PON1质量和芳基酯酶活性,并将其与接受标准血液透析的患者及一组健康对照者(HC)进行比较。

患者与方法

我们测量了15名接受家庭夜间血液透析、15名接受标准血液透析的参与者以及15名健康对照者的PON1芳基酯酶活性和质量、C反应蛋白(CRP)、胱抑素C、总胆固醇和高密度脂蛋白(HDL)胆固醇、甘油三酯、载脂蛋白A-I和载脂蛋白B。

结果

与接受标准血液透析和家庭夜间血液透析的参与者相比,健康对照者的PON1芳基酯酶活性(p < 0.001)和质量(p < 0.05)显著更高,尽管在透析组之间未观察到显著差异。与健康对照者相比,接受标准血液透析者的CRP(p < 0.05)显著更高,且在透析组之间未观察到显著差异。三组之间胱抑素C(p < 0.001)存在显著差异。各组之间在任何脂蛋白参数方面均未观察到显著差异。在透析患者中,PON1活性(r = -0.636,p < 0.001)和质量(r = -0.425,p = 0.019)与CRP呈负相关。

结论

与健康对照者相比,家庭夜间血液透析患者的PON1降低,与HDL胆固醇浓度无关。在接受血液透析的患者中,CRP升高和PON1降低相结合可能提示心血管并发症高危患者。

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